Abstract
This presentation will assess the impact of travel time to the nearest breast cancer mammographic facility on receipt of surveillance mammography following completion of breast cancer treatment. The study population includes women (n=1,312) diagnosed with stage I or stage II breast cancer (TNM classification) from 1990 to 1997 at Group Health Cooperative enrolled in either the Breast Cancer Treatment Effectiveness in Older Women (BOW) or Optimizing Breast Cancer Outcomes: BMI, tumor marker, and quality of care (ACS) retrospective cohort studies. We will obtain information on receipt of screening mammograms up to 5 years after enrollment, women’s demographics at cancer diagnosis, and link them to a geospatial database created to assess distance to nearest mammography facility and area-level socioeconomic characteristics. We will employ generalized linear regression models to assess the relationship between receipt of surveillance mammography following completion of breast cancer treatment and travel time adjusting for women level socio-demographic factors, tumor stage, type of cancer treatment, and comorbidities if they are found significantly related to receipt of mammography. Receipt of surveillance mammography will be defined in two ways:
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ever receiving a surveillance mammogram and
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average surveillance mammogram interval over the 5 years of follow-up.
We will account for different censoring mechanisms, such as recurrence, all cause mortality, breast cancer-specific mortality, and disenrollment from Group Health, and their impact on our measure of receipt of surveillance mammography.
